Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
The journal of nutrition, health & aging
Published in: The journal of nutrition, health & aging 9/2018

01-11-2018 | Editorial

Autonomic Neuropathy and Cardiovascular Disease in Aging

Authors: A. Shams, John E. Morley

Published in: The journal of nutrition, health & aging | Issue 9/2018

Login to get access

Excerpt

Similar to any other systems in the human body, the nervous system undergoes functional decline with aging. These changes have been identified in both central and peripheral components of the nervous systems including the somatic and autonomic branches. Some of the well-known neurological deficits which are associated with aging are hyperopia, presbycusis, diminished sense of taste and smell, loss or impairment of vibratory sense in ankles, and toes, and reduced number of motor end units (1). The autonomic nervous system (ANS) is the nervous system which maintains homeostasis by regulating the function of the heart, the endocrine and exocrine glands, the abdominal viscera, the smooth muscles throughout the body, and the immune system (2) (Figure 1). The ANS is divided into two divisions: the sympathetic thoracolumbar chain outflow and parasympathetic craniosacral outflow (3). Multiple hypotheses have been proposed about changes which occur to the ANS secondary to aging. These appear to be predominantly due to a decline in receptor functionality (4, 5). …
Literature
1.
Ropper, A. H. Adams and Victors principles of neurology. New York: McGraw-Hill Education Medical, 2014.
2.
Cardinali, D. P. Autonomic Nervous System: Basic and Clinical Aspects. Cham: Springer International Publishing, 2018.CrossRef
3.
Daroff, R. B. Bradley’s neurology in clinical practice. London: Elsevier, 2016.
4.
Hotta, H., & Uchida, S. Aging of the autonomic nervous system and possible improvements in autonomic activity using somatic afferent stimulation. Geriatrics & Gerontology International, 2010;10. doi:10.1111/j.1447-0594.2010.00592.x
5.
Ko, D., Preis, S. R., Lubitz, S. A., Mcmanus, D. D., Vasan, R. S., Hamburg, N. M. Mitchell, G. F. Relation of Orthostatic Hypotension With New-Onset Atrial Fibrillation (From the Framingham Heart Study). The American Journal of Cardiology, 2018;121(5), 596–601. doi:10.1016/j.amjcard.2017.11.036CrossRefPubMed
6.
Benarroch, E. E. The clinical approach to autonomic failure in neurological disorders. Nature Reviews Neurology, 2014;10(7), 396–407. doi:10.1038/nrneurol.2014.88CrossRefPubMed
7.
Freeman, R. Neurogenic Orthostatic Hypotension. New England Journal of Medicine, 2008;358(6), 615–624. doi:10.1056/nejmcp074189CrossRefPubMed
8.
Halter JB, Ouslander JG, Studenski S, High KP, Asthana S, Supiano MA, Ritchie C. eds. Hazzard’s Geriatric Medicine and Gerontology, 7e New York, NY: McGraw-Hill
9.
Juraschek, S. P., Daya, N., Rawlings, A. M., Appel, L. J., Miller, E. R., Windham, B. G., Selvin, E. Association of History of Dizziness and Long-term Adverse Outcomes With Early vs Later Orthostatic Hypotension Assessment Times in Middle-aged Adults. JAMA Internal Medicine, 2017;177(9), 1316. doi:10.1001/jamainternmed.2017.2937CrossRefPubMedPubMedCentral
10.
Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. Harrisons principles of internal medicine. New York: McGraw Hill Education, 2015.
11.
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Dijk, J. G. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clinical Autonomic Research, 2011;21(2), 69–72. doi:10.1007/s10286-011-0119-5CrossRefPubMed
12.
Foster-Dingley, J. C., Moonen, J. E., Ruijter, W. D., Mast, R. C., & Grond, J. V. Orthostatic hypotension in older persons is not associated with cognitive functioning, features of cerebral damage or cerebral blood flow. Journal of Hypertension, 2018;36(5), 1201–1206. doi:10.1097/hjh.0000000000001681CrossRefPubMed
13.
Luukinen, H., Koski, K., Laippala, P., & Kivelä, S. Prognosis of Diastolic and Systolic Orthostatic Hypotension in Older Persons. Archives of Internal Medicine, 1999;159(3), 273. doi:10.1001/archinte.159.3.273CrossRefPubMed
14.
Mader, S. L. Low Prevalence of Postural Hypotension Among Community-Dwelling Elderly. JAMA: The Journal of the American Medical Association, 1987;258(11), 1511. doi:10.1001/jama.1987.03400110093033CrossRefPubMed
15.
Catz, A., Mendelson, L., & Solzi, P. Symptomatic postprandial hypotension in high paraplegia. Case report. Spinal Cord, 1992;30(8), 582–586. doi:10.1038/sc.1992.118CrossRef
16.
Strogatz, D. S., Keenan, N. L., Barnett, E. M., & Wagner, E. H. Correlates of Postural Hypotension in a Community Sample of Elderly Blacks and Whites. Journal of the American Geriatrics Society, 1991;39(6), 562–566. doi:10.1111/j.1532-5415.1991. tb03593.xCrossRefPubMed
17.
Kaufmann, H., Freeman, R., Biaggioni, I., Low, P., Pedder, S., Hewitt, L. A., Mathias, C. J. Droxidopa for neurogenic orthostatic hypotension: A randomized, placebo-controlled, phase 3 trial. Neurology, 2014;83(4), 328–335. doi:10.1212/wnl.0000000000000615CrossRefPubMedPubMedCentral
18.
Ricci F, Fedorowski A, Radio F, et al. Cardiovascular morbidity and mortality related to orthostatic hypotension: A meta-analysis of prospective observational studies. Eur Heart J 2015;36:1609–1617.CrossRefPubMed
19.
Fedorowski, A., Engström, G., Hedblad, B., & Melander, O. (2010). Orthostatic Hypotension Predicts Incidence of Heart Failure: The Malmö Preventive Project. American Journal of Hypertension, 2010;23(11), 1209–1215. doi:10.1038/ajh.2010.150CrossRefPubMed
20.
Goldstein, D. S. Dysautonomias: Clinical Disorders of the Autonomic Nervous System. Annals of Internal Medicine, 2002;137(9), 753. doi:10.7326/0003-4819-137-9-200211050-00011CrossRefPubMed
21.
Ramirez, C. E., Okamoto, L. E., Arnold, A. C., Gamboa, A., Diedrich, A., Choi, L. Shibao, C. A. Efficacy of Atomoxetine Versus Midodrine for the Treatment of Orthostatic Hypotension in Autonomic Failure Novelty and Significance. Hypertension, 2014;64(6), 1235–1240. doi:10.1161/hypertensionaha.114.04225CrossRefPubMedPubMedCentral
22.
Krolewski, A. S., Warram, J. H., Cupples, A., Gorman, C., Szabo, A., & Christlieb, A. Hypertension, orthostatic hypotension and the microvascular complications of diabetes. Journal of Chronic Diseases, 1985;38(4), 319–326. doi:10.1016/0021-9681(85)90078-5CrossRefPubMed
23.
Shibao, C., Lipsitz, L. A., & Biaggioni, I. Evaluation and treatment of orthostatic hypotension. Journal of the American Society of Hypertension, 2013;7(4), 317–324. doi:10.1016/j.jash.2013.04.006CrossRefPubMedPubMedCentral
24.
Mancia, G., & Grassi, G. Orthostatic hypotension and cardiovascular risk: Defining the epidemiological and prognostic relevance. European Heart Journal, 2009;31(1), 12–14. doi:10.1093/eurheartj/ehp389CrossRefPubMed
25.
Rutan, G. H., Hermanson, B., Bild, D. E., Kittner, S. J., Labaw, F., & Tell, G. S. Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group. Hypertension, 1992;19(6_Pt_1), 508–519.PubMed
26.
Phipps, M. S., Schmid, A. A., Kapoor, J. R., Peixoto, A. J., Williams, L. S., & Bravata, D. M. Orthostatic hypotension among outpatients with ischemic stroke. Journal of the Neurological Sciences, 2012;314(1-2), 62–65. doi:10.1016/j. jns.2011.10.031CrossRefPubMed
27.
Frith, J., Ng, W., Day, C. P., Payne, B., Sheerin, N., Gorman, G. Newton, J. L. (2014). Orthostatic intolerance is common in chronic disease — A clinical cohort study. International Journal of Cardiology, 2014;174(3), 861–863. doi:10.1016/j. ijcard.2014.04.175CrossRefPubMed
28.
Gupta, V., & Lipsitz, L. A. Orthostatic Hypotension in the Elderly: Diagnosis and Treatment. The American Journal of Medicine, 2007;120(10), 841–847. doi:10.1016/j.amjmed.2007.02.023CrossRefPubMed
29.
Morley, J. E. Frailty, Falls, and Fractures. Journal of the American Medical Directors Association, 2013;14(3), 149–151. doi:10.1016/j.jamda.2012.12.009CrossRefPubMed
30.
Ricci, F., Caterina, R. D., & Fedorowski, A. Orthostatic Hypotension. Journal of the American College of Cardiology, 2015;66(7), 848–860. doi:10.1016/j. jacc.2015.06.1084CrossRefPubMed
31.
Boron, W. F., & Boulpaep, E. L. Medical physiology. Chapter 2017;20, 461–482.e2 Philadelphia: Elsevier, 2017.
32.
Dineen, J., & Freeman, R. Autonomic Neuropathy. Seminars in Neurology, 2015;35(04), 458–468. doi:10.1055/s-0035-1558983CrossRefPubMed
33.
Kanjwal, K., George, A., Figueredo, V. M., & Grubb, B. P. Orthostatic hypotension. Journal of Cardiovascular Medicine, 2015;16(2), 75–81. doi:10.2459/01. jcm.0000446386.01100.35CrossRefPubMed
34.
Low, P. A. Prevalence of orthostatic hypotension. Clinical Autonomic Research, 2008;18(S1), 8–13. doi:10.1007/s10286-007-1001-3CrossRefPubMed
35.
Goldstein, D. S., & Cheshire, W. P. (2017). Beat-to-beat blood pressure and heart rate responses to the Valsalva maneuver. Clinical Autonomic Research, 2017;27(6), 361–367. doi:10.1007/s10286-017-0474-yCrossRefPubMed
36.
Goldstein, D. S., & Sharabi, Y. Neurogenic Orthostatic Hypotension: A Pathophysiological Approach. Circulation, 2009;119(1), 139–146. doi:10.1161/circulationaha.108.805887CrossRefPubMedPubMedCentral
37.
Sánchez-Ferro, Á, Benito-León, J., & Gómez-Esteban, J. C. The Management of Orthostatic Hypotension in Parkinson’s Disease. Frontiers in Neurology, 2013;4. doi:10.3389/fneur.2013.00064
38.
Jones, P. K., Shaw, B. H., & Raj, S. R. Orthostatic hypotension: Managing a difficult problem. Expert Review of Cardiovascular Therapy, 2015;13(11), 1263–1276. doi:10. 1586/14779072.2015.1095090CrossRefPubMedPubMedCentral
39.
Morley, J. E., Rolland, Y., Tolson, D., & Vellas, B. Increasing Awareness of the Factors Producing Falls: The Mini Falls Assessment. Journal of the American Medical Directors Association, 2012;13(2), 87–90. doi:10.1016/j.jamda.2011.11.002CrossRefPubMed
40.
Ci, W., & E, T. Syncope: Dietary advice to help manage the symptoms of syncope. Integrative Food, Nutrition and Metabolism, 2016;3(5). doi:10.15761/ifnm.1000165
41.
Gillis, D. J., Wouda, M., & Hjeltnes, N. Non-pharmacological management of orthostatic hypotension after spinal cord injury: A critical review of the literature. Spinal Cord, 2008;46(10), 652–659. doi:10.1038/sc.2008.48CrossRefPubMed
42.
Arnold, A. C., & Shibao, C. Current Concepts in Orthostatic Hypotension Management. Current Hypertension Reports, 2013;15(4), 304–312. doi:10.1007/s11906-013-0362-3CrossRefPubMedPubMedCentral
43.
Figueroa, J. J., Basford, J. R., & Low, P. A. Preventing and treating orthostatic hypotension: As easy as A, B, C. Cleveland Clinic Journal of Medicine, 2010;77(5), 298–306. doi: 10.3949/ccjm.77a.09118CrossRefPubMedPubMedCentral
44.
Fouad-Tarazi, F. M., Okabe, M., & Goren, H. Alpha sympathomimetic treatment of autonomic insufficiency with orthostatic hypotension. The American Journal of Medicine 1995;99(6), 604–610. doi:10.1016/S0002-9343(99)80246-0CrossRefPubMed
45.
Hoeldtke, R. D., Davis, K. M., Joseph, J., Gonzales, R., Panidis, I. P., & Friedman, A. C. Hemodynamic effects of octreotide in patients with autonomic neuropathy. Circulation, 1991;84(1), 168–176. doi:10.1161/01.cir.84.1.168CrossRefPubMed
46.
Hoeldtke, R. D., Horvath, G. G., Bryner, K. D., & Hobbs, G. R. Treatment of Orthostatic Hypotension with Midodrine and Octreotide. The Journal of Clinical Endocrinology, & Metabolism, 1998;83(2), 339–343. doi:10.1210/jcem.83.2.4534
47.
Hoeldtke, R. D., & Streeten, D. Treatment of Orthostatic Hypotension with Erythropoietin. New England Journal of Medicine, 1993;329(9), 611–615. doi:10.1056/nejm199308263290904CrossRefPubMed
48.
Kaufmann, H., Norcliffe-Kaufmann, L., & Palma, J. Droxidopa in neurogenic orthostatic hypotension. Expert Review of Cardiovascular Therapy, 2015;13(8), 875–891. doi:10.1586/14779072.2015.1057504CrossRefPubMedPubMedCentral
49.
Mathias, C. J., Fosbraey, P., Costa, D. F., Thornley, A., & Bannister, R. The effect of desmopressin on nocturnal polyuria, overnight weight loss, and morning postural hypotension in patients with autonomic failure. Bmj, 1986;293(6543), 353–354. doi:10.1136/bmj.293.6543.353CrossRefPubMed
50.
Maule, S., Papotti, G., Naso, D., Magnino, C., Testa, E., & Veglio, F. Orthostatic Hypotension: Evaluation and Treatment. Cardiovascular & Hematological Disorders-Drug Targets, 2007;7(1), 63–70. doi:10.2174/187152907780059029CrossRef
51.
Mcdonald, C., Newton, J. L., & Burn, D. J. Orthostatic hypotension and cognitive impairment in Parkinson’s disease: Causation or association? Movement Disorders, 2016;31(7), 937–946. doi:10.1002/mds.26632CrossRefPubMed
52.
Metzler, M., Duerr, S., Granata, R., Krismer, F., Robertson, D., & Wenning, G. K. Neurogenic orthostatic hypotension: Pathophysiology, evaluation, and management. Journal of Neurology, 2012;260(9), 2212–2219. doi:10.1007/s00415-012-6736-7CrossRefPubMedPubMedCentral
53.
Omara, G., & Lyons, D. Postprandial hypotension. Clinics in Geriatric Medicine, 2002;18(2), 307–321. doi:10.1016/s0749-0690(02)00012-5CrossRef
54.
Verwaerde, P., Tran, M., & Montastruc, J. Effects of yohimbine, an a2-adrenoceptor antagonist, on experimental neurogenic orthostatic hypotension. Fundamental & Clinical Pharmacology, 1997;11(6), 567–575. doi:10.1111/j.1472-8206.1997. tb00862.xCrossRef
55.
Lanier JB1, Mote MB, Clay EC. Evaluation and management of orthostatic hypotension. American Family Physician, 2011;84(5):527–536.PubMed
56.
57.
Arnold AC, Ng J, Raj SR. Postural tachycardia syndrome–diagnosis, physiology, and prognosis. Auton Neurosci 2018;Feb 28. Doi: 10.1016/.autneu.2018.02.005 (Epub ahead of print).
58.
Raj V, Opie M, arnold aC. Cognitive and psychological issues in postural tachycardia syndrome. Auton Neurosci 2018;Mar 27 doi: 10.1016/j.autneu.2018.03.004.
59.
Garland EM, Celedonio JE, Raj SR. Postural tachycardia syndrome: Beyond orthostatic intolerance. Curr Neurol Neurosci Rep 2015;15:60. Doi: 10.1007/s11910-015-0583-8.CrossRefPubMedPubMedCentral
60.
Novak P. Orthostatic cerebral hypoperfusion syndrome. Front Aging Neurosci 2016;8:22. Doi: 10.3389/fnagi.2016.00022. eCollection.PubMedPubMedCentral
61.
Metwalley KA, Hamed SAA, Farghaly HS. Cardiac autonomic function in children with type 1 diabetes. Eur J Pediatr 2018;Mar 2. Doi: 10.1007/s00431-018-3122-1 [Epub ahead of print].
62.
Kanjwal K, Karabin B, Kanjwal Y, Grubb BP. Autonomic dysfunction presenting as postural orthostatic tachycardia syndrome in patients with multiple sclerosis. Int J Med Sci 2010;7:62–67.CrossRefPubMedPubMedCentral
63.
Ruzieh M, Grubb BP. Orthostatic intolerance and postural tachycardia syndrome: New insights into pathophysiology and treatment. Herzschrittmacherther Elektrophysiol 2018; Apr 25. Doi: 10.10007/s00399018-0563-1 [Epub ahead of print].
64.
Edwards BJ, Perry HM 3rd, Kaiser FE, et al. Relationship of age and calcitonin generelated peptide to postprandial hypotension. Mech Ageing Dev 1996;87:61–73.CrossRefPubMed
65.
66.
Trahair LG, Horowitz M, Jones KL. Postprandial hypotension: A systematic review. J A Med Dir Assoc 2014;15:394–409.CrossRef
67.
Jansen, R. W., & Lipsitz, L. A. Postprandial Hypotension: Epidemiology, Pathophysiology, and Clinical Management. Annals of Internal Medicine, 1995;122(4), 286. doi:10.7326/0003-4819-122-4-199502150-00009CrossRefPubMed
68.
Zou, X., Cao, J., & Li, J. Prevalence of and risk factors for postprandial hypotension in older Chinese men. Journal of Geriatric Cardiology, 2015;12(6), 600–604. doi:10.11909/j.issn.1671-5411.2015.06.003PubMed
69.
Pavelic, A., Skoric, M. K., Crnošija, L., & Habek, M. Postprandial hypotension in neurological disorders: Systematic review and meta-analysis. Clinical Autonomic Research, 2017;27(4), 263–271. doi:10.1007/s10286-017-0440-8CrossRefPubMed
70.
Teramoto, S., Akishita, M., Fukuchi, Y., Toba, K., & Ouchi, Y. Assessment of Autonomic Nervous Function in Elderly Subjects with or without Postprandial Hypotension. Hypertension Research, 1997;20(4), 257–261. doi:10.1291/hypres.20.257CrossRefPubMed
71.
Aronow, W. S., & Ahn, C. Association of Postprandial Hypotension with incidence of falls, syncope, coronary events, stroke, and total mortality at 29-month follow-up in 499 older nursing home residents. Journal of the American Geriatrics Society, 1997;45(9), 1051–1053. doi:10.1111/j.1532-5415.1997.tb05965.xCrossRefPubMed
72.
Barochiner J, Alfie J, Aparicio LS, et al. Postprandial hypotension detected through home blood pressure monitoring: A frequent phenomenon in elderly hypertensive patients. Hypertension Research, 2013;37(5), 438–443. doi:10.1038/hr.2013.144CrossRefPubMed
73.
Idiaquez, J., Rios, L., & Sandoval, E. Postprandial hypotension in Alzheimers disease. Clinical Autonomic Research, 1997;7(3), 119–120. doi:10.1007/bf02308837CrossRefPubMed
74.
Tabara, Y., Okada, Y., Uetani, E., Nagai, T., Igase, M., Kido, T., Miki, T. Postprandial hypotension as a risk marker for asymptomatic lacunar infarction. Journal of Hypertension, 2014;32(5), 1084–1090. doi:10.1097/hjh.0000000000000150CrossRefPubMed
75.
Trahair, L. G., Horowitz, M., & Jones, K. L. Postprandial Hypotension: A Systematic Review. Journal of the American Medical Directors Association, 2014;2014;15(6), 394–409. doi:10.1016/j.jamda.2014.01.011CrossRefPubMed
76.
Van Orshoven, N. P., Jansen, P. A., Oudejans, I., Schoon, Y., & Oey, P. L. Postprandial Hypotension in Clinical Geriatric Patients and Healthy Elderly: Prevalence Related to Patient Selection and Diagnostic Criteria. Journal of Aging Research, 2010, 1–7. doi:10.4061/2010/243752
77.
Luciano, G. L., Brennan, M. J., & Rothberg, M. B. Postprandial Hypotension. The American Journal of Medicine, 2010;123(3). doi:10.1016/j.amjmed.2009.06.026
78.
Morley, J. E. The Aging Gut: Physiology. Clinics in Geriatric Medicine, 2007;23(4), 757–767. doi:10.1016/j.cger.2007.06.002CrossRefPubMed
79.
Puisieux, F., Bulckaen, H., Fauchais, A. L., Drumez, S., Salomez-Granier, F., & Dewailly, P. Ambulatory Blood Pressure Monitoring and Postprandial Hypotension in Elderly Persons With Falls or Syncopes. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2000;55(9). doi:10.1093/gerona/55.9.m53
80.
Maurer, M. S. Upright Posture and Postprandial Hypotension in Elderly Persons. Annals of Internal Medicine, 2000;133(7), 533. doi:10.7326/0003-4819-133-7-200010030-00012CrossRefPubMed
81.
Shannon, J. R., Diedrich, A., Biaggioni, I., Tank, J., Robertson, R. M., Robertson, D., & Jordan, J. Water drinking as a treatment for orthostatic syndromes. The American Journal of Medicine, 2002;112(5), 355–360. doi:10.1016/s0002-9343(02)01025-2CrossRefPubMed
82.
Morley, J. E. Gait, Falls, and Dementia. Journal of the American Medical Directors Association, 2016;17(6), 467–470. doi:10.1016/j.jamda.2016.03.024CrossRefPubMed
83.
Lange-Maia BS, Newman AB, Jakicic JM, et al. Relationship between sensorimotor peripheral nerve function and indicators of cardiovascular autonomic function in older adults from the Health, Aging and Body Composition Study. Exp Gerontol 2017;96:38–45.CrossRefPubMedPubMedCentral
84.
85.
86.
Morley JE, Asvat MS, Klein L, Lowenthal MN. Autonomic neuropathy in Black diabetic patients. S Am Med J 1977;52:115–116.
87.
Allan LM, Ballard CG, Allen J, Murray A, Davidson AW, McKeith IG, Kenny RA. Autonomic dysfunction in dementia. J Neurol Neurosurg Psychiatry 2007;78:671–677.CrossRefPubMed
88.
Taralov ZZ, Terziyski KV, Kostianev SS. Heart rate variability as a method for assessment of the autonomic nervous system and the adaptations to different physiological and pathological conditions. Folia Med (Plovdiv) 2015;57:173–180.CrossRef
89.
da Silva VP, Ramalho Oliveira BR, Tavares Mello RG, et al. Heart rate variability idexes in dementia: A systematic review with a quantitative analysis. Curr Alzheimer Res 2018;15:80–88.PubMed
90.
Sciaraffia E, Chen J, Hocini M, et al. Use of event recorders and loop recorders in clinical practice: Results of the European Heart Rhythm Association survey. Europace 2014;16:1384–1386.CrossRefPubMed
91.
Kapoor, W. N. Syncope. New England Journal of Medicine, 2000;343(25), 1856–1862. doi:10.1056/nejm200012213432507
92.
Morley, J. E. White Matter Lesions (Leukoaraiosis): A Major Cause of Falls. Journal of the American Medical Directors Association, 2015;16(6), 441–443. doi:10.1016/j. jamda.2015.03.023CrossRefPubMed
93.
Fox, M. C., Lakdawala, N., Miller, A. L., & Loscalzo, J. A Patient with Syncope. New England Journal of Medicine, 2013;369(10), 966–972. doi:10.1056/nejmcps1300093CrossRefPubMed
94.
Makowiec, D., Graff, B., & Struzik, Z. R. Multistructure index characterization of heart rate and systolic blood pressure reveals precursory signs of syncope. Scientific Reports, 2017;7(1). doi:10.1038/s41598-017-00354-x
95.
Shen, W., & Sheldon, R. S. Assessment and Treatment of Syncope. JAMA Cardiology, 2017;2(8), 920. doi:10.1001/jamacardio.2017.1784CrossRefPubMed
96.
Shen, W., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D, Yancy, C. W. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients with Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation, 2017;136(5). doi:10.1161/cir.0000000000000499
97.
Palmisano, P., Accogli, M., Zaccaria, M., Luzzi, G., Nacci, F., Anaclerio, M., & Favale, S. Predictive factors for pacemaker implantation in patients receiving an implantable loop recorder for syncope remained unexplained after an extensive cardiac and neurological workup. International Journal of Cardiology, 2013;168(4), 3450–3457. doi:10.1016/j.ijcard.2013.04.179CrossRefPubMed
Metadata
Title
Autonomic Neuropathy and Cardiovascular Disease in Aging
Authors
A. Shams
John E. Morley
Publication date
01-11-2018
Publisher
Springer Paris
Published in
The journal of nutrition, health & aging / Issue 9/2018
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-018-1097-2

Other articles of this Issue 9/2018

The journal of nutrition, health & aging 9/2018 Go to the issue

OriginalPaper

Insufficient Protein Intake is Highly Prevalent among Physically Active Elderly

OriginalPaper

Long and Short Sleep Duration and Physical Frailty in Community-Dwelling Older Adults

OriginalPaper

Survey on Physical Fitness and Cardiovascular Function of the City Elderly in Different Regular Physical Activities in China

Editorial

Nutrition and Frailty

OriginalPaper

Frailty Related Factors as Predictors of Functional Recovery in Geriatric Rehabilitation: The Sarcopenia and Function in Aging Rehabilitation (SAFARI) Multi-Centric Study

OriginalPaper

Reliability and Validity of Turkish Version of the Simplified Nutritional Appetite Questionnaire (SNAQ)
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits